Gender Reassignment Therapy

There is significant controversy regarding whether it is appropriate to administer therapy to minors or perform surgery on minors that suppresses their birth gender and amplifies the characteristics of another gender. The controversy stems from the observation that some adults state that they have known since childhood that they wished to be another gender, but were forced to act and behave in conformity with the expectations of their birth gender assignment, and that this forced conformity has harmed their psychological development and caused them severe suffering.

Gender reassignment therapy should not be allowed until brain imaging studies have been performed demonstrating that the area of the brain corresponding to gender identity corresponds to the gender preference expressed by the minor. Imaging results are not valid until 4 years of age, at which time the size of the nucleus in the brain involved in sexual identity has reached maximum size. [SWAAB, D. F. & HOFMAN, M. A. (1988). Sexual differentiation of the human hypothalamus: ontogeny of the sexually dimorphic nucleus of the preoptic area. Developmental Brain Research.]

Background:

During the 1980s AIDS epidemic many victims of HIV donated their bodies to science. At autopsy, measurements were taken of an area of the brain now called the sexually dimorphic nucleus of the hypothalamus (SDNH). The area was found to be 2.2 times larger in heterosexual men than in heterosexual women, and 2 times larger in heterosexual men than in homosexual men. [LeVay S (1991). "A difference in hypothalamic structure between heterosexual and homosexual men". Science. 253 (5023): 1034–1037.]

During the development of the fetus, external physical sexual characteristics are developed before the SDNH develops. A study in fetal mice was conducted in which testosterone was either blocked in male (XY) mice or boosted in female (XX) mice. This resulted in adult mice with external genitalia of one gender but with sexual behaviors of the other gender. In humans the window between development of external genitalia and development of the SDNH is about 2 weeks. It has been theorized that during this time span some mothers have antibodies to testosterone that can interfere with appropriate development of the SDNH. This is based on the fact that the second male child of a mother is significantly more likely to be homosexual than the first male child.